富含ω-3多不饱和脂肪酸肠内营养制剂对重型颅脑损伤患者免疫平衡的影响

Effect of Enteral Nutrition Preparations Rich in Omega-3 Polyunsaturated Fatty Acids on Immune Balance in Patients with Severe Traumatic Brain Injury

目的观察富含ω-3多不饱和脂肪酸肠内营养制剂对重型颅脑损伤患者免疫平衡的影响。方法选择2019年6月~2021年6月因重型颅脑损伤术后进入某院重症医学科加强监护治疗的患者42名,随机分为对照组[肠内营养混悬液(SP,百普力组),n=20]和实验组[肠内营养乳剂组(TPF-T,瑞能),n=22]两组,患者在进入重症医学科后立即抽血行降钙素原(PCT)、外周血淋巴细胞总数、IL-2、IL-6、IL-10等检查。两组患者均经空肠营养管进行早期肠内营养支持,然后在入科后第48 h、72 h、96 h、7 d复测相关指标。通过对比上述数据的变化来评估富含ω-3多不饱和脂肪酸肠内营养制剂对重型颅脑损伤患者免疫平衡的影响。结果在PCT的变化上,实验组与对照组无统计学差异(P>0.05)。在外周血淋巴细胞总数的变化上,实验组在进行肠内营养72h后明显高于对照组,差异具有统计学意义(P<0.05)。在IL-2、IL-6、IL-10的变化上,实验组在进行肠内营养96 h后明显低于对照组,差异具有统计学意义(P<0.05)。结论富含ω-3多不饱和脂肪酸肠内营养制剂可能有助于降低重型颅脑损伤患者过度的炎症反应,改善免疫状态。

OBJECTIVE To investigate the effect of enteral nutrition preparations rich in omega-3 polyunsaturated fatty acids on immune balance in patients with severe traumatic brain injury.METHODS A total of 42 patients who entered the Department of Critical Care Medicine of the one Hospital of after surgery for severe traumatic brain injury in 2019.06~2021.06 were randomly divided into two groups:control group(SP group,n=20)and experimental group(TPF-T group,n=22).The blood was drawn for procalcitonin(PCT),total number of peripheral blood lymphocytes,IL-2,IL-6,IL-10 and other examinations immediately.Both groups of patients were supported by early enteral nutrition through jejunal nutrition tubes,and then retested for relevant indicators at 48h,72h,96h,and 7d after admission.The effect of enteral nutrition preparations rich in omega-3 polyunsaturated fatty acids on immune balance in patients with severe traumatic brain injury was evaluated by comparing changes in the above data.RESULTS There was no significant difference between the experimental group and the control group in the change of PCT(P>0.05).In terms of the change of the total number of peripheral blood lymphocytes,the experimental group was significantly higher than the control group after enteral nutrition for 72 h,and the difference was statistically significant(P<0.05).In terms of the changes of IL-2,IL-6 and IL-10,the experimental group was significantly lower than the control group after enteral nutrition for 96h,and the difference was statistically significant(P<0.05).CONCLUSION Enteral nutrition preparations rich in omega-3 polyunsaturated fatty acids may can help reduce excessive inflammation and improve immune status in patients with severe traumatic brain injury.